Comparison of amlodipine/valsartan/hydrochlorothiazide single pill combination and free combination: adherence, persistence, healthcare utilization and costs

Objectives: To determine whether amlodipine/valsartan/hydrochlorothiazide single pill combination (SPC) is associated with improved persistence, adherence and reduced healthcare utilization and costs compared to the corresponding free combination (FC). Methods: Adult (≥18 years) patients covered by...

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Bibliographic Details
Published in:Current medical research and opinion 2015-12, Vol.31 (12), p.2287-2296
Main Authors: Machnicki, G., Ong, S.H., Chen, W., Wei, Z.J., Kahler, K.H.
Format: Article
Language:English
Subjects:
Adherence
Aged
Aged, 80 and over
Amlodipine - administration & dosage
Antihypertensive Agents - administration & dosage
Cohort Studies
Costs
Drug Combinations
Female
Healthcare utilization
Hospitalization
Humans
Hydrochlorothiazide - administration & dosage
Hypertension
Hypertension - drug therapy
Male
Medication Adherence
Middle Aged
Patient Acceptance of Health Care
Persistence
Retrospective Studies
Single pill combination
Valsartan - administration & dosage
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Summary:Objectives: To determine whether amlodipine/valsartan/hydrochlorothiazide single pill combination (SPC) is associated with improved persistence, adherence and reduced healthcare utilization and costs compared to the corresponding free combination (FC). Methods: Adult (≥18 years) patients covered by commercial and Medicare Supplemental insurance in the Truven MarketScan database with hypertension (HTN) diagnosis between October 2009 and December 2011 were included. At least two filled prescriptions for the SPC cohort or two periods of minimum 15 days of concurrent use of amlodipine, valsartan and hydrochlorothiazide (HCT) for the FC cohort were required. Cohorts were propensity score matched (PSM) to balance on important confounders. Outcomes included: 1) adherence (proportion of days covered [PDC] and medication possession ratio [MPR]); 2) persistence (treatment gap >30 days); 3) all-cause and HTN-specific healthcare utilization and costs at 12 months. Results: After cohort matching with PSM, patients taking SPC (N = 9221) exhibited better outcomes than FC (N = 1884): higher mean adherence (85.7% vs. 77.0%), mean PDC (73.8% vs. 60.6%) and persistence (46.8% vs. 23.6%) (all p 
ISSN:0300-7995
1473-4877
DOI:10.1185/03007995.2015.1098598